The Hip Unit, as well as all ICATME, have successfully started elective non-urgent surgical activity (for example: arthrosis surgery, femoroacetabular shock, hip dysplasia, …) since the beginning of May. of the SAFE HOSPITAL protocol that emerged from the adaptation of the protocols of the German Society of Orthopedic Surgery (DGOOC), International Hip Society (IHS), American Association of Hip and Knee Surgeons (AAHKS) and European Society of Arthroscopy of the knee and Sports (ESSKA), presenting its widely satisfactory results, protecting patients who have not suffered from COVID disease as well as those who were cured of asymptomatic positive COVID patients, by means of specific clinical and radiological examinations mandatory in the Dexeus University Hospital, Grupo Quirón Salud.

For the interest of readers, both healthcare and non-healthcare, an image is left that corresponds to the outline chart of the Safe Hospital protocol that is followed for the introduction of surgical patients according to the strictest safety standards.

On May 23 the Venezuelan Society of Orthopedic Surgery and Traumatology (SVCOT) organizes an international telematic Congress, with the assistance of specialists from both continents.

Dr Ribas and Cardenas present their achievements and their experience in the diagnosis and treatment of femoroacetabular shock (known in Central and South America as Femoroacetabular Impingement).

With more than 2,000 interventions carried out, the Hip Unit has emerged as one of the benchmarks in the treatment of this pathology, the first cause of pain in the athlete’s hip and the first mechanical cause of arthrosis in said joint.

In addition to exposing cases of femoroacetabular shock, clinical cases of other mechanical hip pathologies that need to be differentiated are presented. The most frequently confused with femoroacetabular shock is residual hip dysplasia. Both cause chondrolabral lesions to evolve freely, but the treatment of the cause is completely different: while femoroacetabular shock is treated with remodeling of the acetabular overlay and femoral hump, residual dysplasia is treated by redirecting the acetabulum to provide physiological coverage . This is obtained through periacetabular osteotomy, a technique of which this Unit is a reference center in Europe for its mini-invasive technique.

The Hip Unit has successfully returned to its usual activity. In a very satisfactory way, maintaining the “negative Covid circuit” protocol implemented by ICATME and Dexeus University Hospital, which isolates and protects patients who have not suffered from Covid-19 and those who have been cured.

The care activity of patients with pathologies of the locomotor system is resumed.

1. You must wear the mask.
2. Try to be punctual, neither before nor after the indicated time.
3. Only the patient will be able to access the consultation, unless he is a dependent or a minor.
4. Respect the social distance of 2m.

After the stabilization of infections by COVID 19, the Quirón Dexeus University Hospital and consequently ICATME, we have gradually resumed our activity. To do this, we have restructured the physical space of our consultations and waiting rooms, with the aim of avoiding crowds and guaranteeing physical distance. In addition to the reforms of the workspace, the state of the professionals is monitored day by day.

For this new phase, ICATME has a Coronavirus prevention manual, of which we can highlight:

Visiting times have been spaced

Consultation hours have been increased with a greater demand for punctuality

Visiting time is minimized, to avoid crowding between patients

It is essential to have an Appointment to be attended at our facilities

The use of a mask is mandatory

You must go to the appointment at the exact time, neither before nor after.

In these conditions, with an exhaustive preoperative procedure focused on the Coronavirus, with the measures established in the operating rooms and the measures adopted by ICATME in the doctor’s offices, we can offer a safe environment to carry out surgical interventions, and follow-up in our facilities in person. and by telemedicine, if applicable, to avoid avoidable displacement.

With a worldwide telematic audience of more than 500 medical specialists in hip arthroscopy, Dr Cárdenas places his emphasis on the surgical treatment of space conflicts around the hip, also treatable by arthroscopy.

Today Dr Cárdenas is considered one of the world’s greatest specialists in the field.

From the Hip Unit we want to thank Professor Kjeld Söballe (Aarhus -Denmark), brilliant hip and pelvic surgeon, former chairman of the scientific committee of the European Hip Society (EHS); he in 2006 (2 years before I published it in the American Journal JBJS Am 2008) taught me the mini-invasive technique. Our fortune is to have known him, his generosity, didactic commitment. We can never thank him as he deserves.

First of all thank you friend Kjeld.

He was the one who realized that Ganz periacetabular osteotomy could be done by a mini-invasive approach that does not compromise the muscles, produces less bleeding, much less postoperative pain, and a faster return to everyday activities, including sport.

Today there is an undetermined number of athletes with moderate dysplasia, with a ratio of 4 to 5 women to 1 man, although there are ethnic and genetic factors. Low-grade dysplasia is not always detected at birth or during the first year of life.

Mini-invasive periacetabular osteotomy requires a highly specialized and coordinated medical and nursing team. We can see in the image Dr. Luis Ramírez placing the screws while Dr. Ribas maintains the correct redirection of the acetabulum to give normal three-dimensional coverage of the femoral head by the acetabulum. In our experience, there is no limit or residual standard dysplasia that is the same as another. Treatment is individualized patient by patient under a detailed preoperative calculation. We recommend reading on Instagram – Linkedin or on Twitter of “Periacetabular osteotomy step by step” by Dr. Luis Ramírez.

As we have been able to read in media such as the Medical Writing or the German newsletter BR24, a study carried out by the University of Eindhoven (Netherlands) together with the Catholic University of Leuven (Belgium), shows that the virus particles that remain floating in the air when we are in motion, they require a greater distance between people.

The study’s recommendation is that we should maintain a distance of 4m when walking and more than 10m when running.

Although the Hip Unit is aimed at young people and young adults with dysplasia, often not noticed during childhood, it occurred in the 2nd, 3rd and 4th decades of life. This work, published in the largest Spanish journal of Orthopedics and Traumatology, represents the first work published on this mini-invasive technique throughout Central Europe and Southern Europe.

To thank our colleague Dr. Luis José Ramírez, specialist and member of the Unit staff, and the fellows we have had in recent years who, with their dedication, have made this work of data collection, angle measurement and analysis possible. statistical.

We could have perfectly published this work in an international magazine, but we believe that we owe it to our country. Disseminate knowledge of this technique in our field. This is how fundamentally Spanish and Spanish-speaking medical colleagues can access such precious and uplifting information.

I thank Dr. Luis José Ramírez for his dedication to the subject, the subject of his Doctoral Thesis, under the baton of the Professor at the University of Barcelona Andreu Combalía and myself (Dr. Manuel Ribas) as his tutor.

New works will appear, already more specific in the line of his Doctoral Thesis, as well as in the field of dysplastic athletes. Recently in the American Journal of Sports Medicine it was reported that 21% of Scandinavian soccer players suffered from hip pain as a result of residual dysplasia, and 46% from borderline dysplasia. In these cases, individual assessment is essential to offer the most appropriate treatment: simple arthroscopic treatment, repair of chondrolabal lesions in borderline dysplasia, arthroscopic treatment associated with mini-invasive periacetabular osteotomy or just mini-invasive periacetabular osteotomy.

For now, the Dexeus University Hospital is the only one in the South of Europ, which has carried out, since 2007, periacetabular osteotomy using a mini-invasive technique.

Dr Ribas participated in the Virtual Seminar on Double Mobility organized in Argentina this April 22, 2020.

For more than a decade, with the appearance of the new high cross linked polyethylene (HXLPE), the double mobility system born in France in 1974 by Prof Gils Bousquet (a 22 to 28 mm femoral head articulated with a large diameter HXLPE head) has enormous popularity, since in addition to providing great stability (superior to all conventional systems), it provides excellent clinical-functional results and durability. In the beginning, the polyethylene which if used in the present case is not comparable to actuality.
Nowadays the system with the improved polyethylene (HXLPE) holds very precise indications, especially in situations with special risk of dislocation, reducing these practically to zero. For this reason, in 2009, the North American FDA approved on use with the already new HXLPE.

In said seminar Drs. Ricardo Munafó and Federico Manfrin, expert in Duomobility in Argentina make an update. Dr. Manfrin explains the hip unit protocol of the University Hospital Dexeus as a case of his own Ribas.

The Duomobility represents a valid alternative in different situations as the Ribas includes in its protocol.

During the ascent phase and the peak phase of the Covid 19 pandemic curve, the Hip Unit has only deferred those non-urgent interventions (also called “electives”) following the rules dictated by the Alarm State Decree.

The protocols have been followed in the entire group of Quirónsalud hospitals. With the proper protection regulations, both for patients and healthcare personnel, and in completely separate circuits for Covid – and + patients, we have managed to satisfactorily attend to hip emergencies and their corresponding interventions.

Consultations have been made in the form of a telephone and telematic visit, to minimize the presence of patients in hospital facilities. In the case that attendance has been compulsory, they have been carried out with due spatial and temporal separation.

These prevailing rules will be followed until further notice. However, the ICATME hip unit, in view of the de-escalation of the curve in Spain, will resume its activity in a very short time under extremely strict preoperative, intraoperative and extraoperative protocols.

From here we want to thank the Quirónsalud group and its network of professionals, and especially those with whom we work at the Dexeus University Hospital for making it possible.

Dr Ribas participates in the Webinar, promoted by the German Society DGOOC for German speaking countries. In this virtual congress the operation of the Hip Unit during the pandemic in its different phases was explained.

A protocol for restarting habitual surgical activity was also discussed based on those proposed by the same DGOOC, AAHKS, IHS, ESSKA (scientific societies of the specialty in Europe and North America).

Communicated as of March 16, 2020 in relation to the current situation of the Coronavirus and its effects on visits and surgeries of the Hip Unit of ICATME – Hospital Universitari Dexeus.

Starting today, Monday the 16th and after the urgent meetings held over the weekend with the health authorities of the Hospital and the management of ICATME, it has been decided, acting with the greatest responsibility, to take the following measures, which will be subject to modifications as they change. the situation in the coming days:

Reschedule surgeries until April 1. Cases of preferential or necessary assistance are maintained

Limit non-urgent visits in the same period. Attendance is guaranteed for patients who come to the face-to-face visit in our center. Urgent cases will also be attended in person.

Patients who, due to the situation of confinement, wish to make a telematic visit or telephone consultation should contact:
Telephone: 93 205 43 62
E-mail: info@icatme.com
www.icatme.com
www.micadera.es
One of our team members will be available to address your concern

Surgical emergencies are maintained, a rotating system of guards has been established to provide coverage in case of emergency
The doctors who will provide in-person assistance follow all the protocols and recommendations to limit the transmission of the virus.

At ICATME the well-being of our patients has always been a priority. The activity is maintained in a controlled way to provide coverage to those who need it.

Dr. Víctor Aguirre is appointed by the Mexican College of Orthopedics and Traumatology Medical Holder in the Chapter of Hip and Knee Surgery for the Biennium 2020 and 2021.

The tasks attributed to this appointment for the whole country are:

Realization and coordination of academic programs related to hip and knee surgery during national congresses.

Promote periodic meetings between surgeons in the field of Hip and Knee Surgery after identifying and updating the entire Mexican community with the most recent advances, in other words, promoting and maintaining the scientific update.

Our most sincere congratulations to Dr. Victor Aguirre, whose training stay in the hip subspecialty in our unit has left us with a deep imprint.

After his formative stay in the Hip Unit, Dr. Víctor Aguirre performs periacetabular osteotomy for the treatment of adult residual dysplasia according to the mini-invasive technique, which in his day, 14 years ago, Ribas learned from Professor Kjeld Søballe and that other doctors of the Unit (Dr Carlomagno Cárdenas) also perform.

As we have already announced through our Twitter account, the reviewers and the scientific editorial confirm their next publication in the Spanish journal of Orthopedics and Traumatology.

This is the description of the periacetabular Ganz mini-invasive technique by Søballe mini-approach (JBJS Am 2008) with the technical variants developed by the Hip Unit itself and its results in the medium term, in a significant number of cases ( 131), which today have exceeded five hundred. It is the greatest experience in this technique in all of southern Europe.

The first signatory, developer and lead author is Dr. Ramírez-Núñez, helped by Dr. Ribas, who is carrying out a line of work and publications on this subject, which will soon bear fruit. From here, our most sincere thanks to the fellows who, during these years, have made possible, with their collaboration, such a great database.

Remember also that Dr. Ribas learned periacetabular osteotomy from the hands of Dr. Robert Trousdale in 2003 during his stay at the Mayo Clinic with Dr. Oliver Marín of Madrid and Dr. Javier Camacho of Mexico City. He started it in September 2003 and in his mini-invasive variant in 2007, after his stay in Denmark with Professor Söballe (one year before its publication in the JBJS Am 2008).

Dr Ribas, for the third consecutive year, participates in the official congress of the Mexican Society of Hip Surgery in the company of famous world-famous surgeons such as Professor Reinhold Ganz, Professor Miguel Cabanela, Professor David Kendoff, Professor Mariano Fernández Fairén and the most recognized hip surgeons in the Central American country.

On this occasion there will even be an extra day of live surgery, in which Dr. Ribas will carry out jointly with expert surgeons from the country trained in the hip unit of Dexeus University Hospital, Dr. Victor Aguirre and Dr. Edwin a periacetabular osteotomy of Ganz but via mini-invasive, which will be commented live to the auditorium by Professor Reinhold Ganz himself.

This is the first time that Dr. Manuel Ribas has performed Ganz periacetabular osteotomy, in his minimally invasive variant approach, in the presence of its inventor, in 1988, the very and very honorable Professor Reinhold Ganz. As always, Dr. Ribas had recognition during his speech; not surprisingly, Dr Ribas translated this technique from German into Spanish in the “Operative Orthopädie und Traumatology” magazine by Springer (1990), published in Spanish by Doyma Publishing.

Dr Ribas always dedicated himself to the translation of articles and techniques published in said magazine during the following 13 years. That meant a great acquisition of knowledge in the specialty of Orthopedic Surgery and Traumatology. Currently this journal is indexed medline and Dr. Ribas already has published various techniques in the field of hip surgery.

During these days, you will also have the opportunity to give other master readings in the field of femoroacetabular shock surgery, pain surgery in the pubic-inguinal complex (of which it is a world reference, with techniques that bear the same name), of the ruptures of the gluteal tendons at the level of the greater trochanter (the so-called trochanteritis and even trochanteric bursitis), of the acetabular labrum transplant and finally, will also talk about the mini-invasive periacetabular osteotomy in athletes.

Last Monday, in the capital of Dubai Abi Dhabi, the advanced medical assistance plan for the citizens of that emirate state was presented to the Dubai Ministry of Health.

Two representatives of Icatme, Professor Enric Cáceres and Dr Ignacio Ginebreda, presented to the country’s authorities the program of comprehensive specialized assistance based on excellence, in which the Hip Unit will have, like the other Icatme units, a relevant role The Quirónsalud group manager, Don German Barraqueta, signed two MOUs (Memorandum for Organization and Understanding) with the health authorities of Dubai and Abu Dhabi.

This fact highlights the expansive nature of knowledge that exists in the world about the whole group, always linked to evidence-based medicine but also excellence.

In a few days, confirmation of publication of different works in indexed scientific journals by the Hip Unit has been received:

Periacetabular osteotomy in the treatment of hip dysplasia through mini-invasive technique. Our medium-long term results in 131 patients. Periacetabular osteotomy for hip dysplasia treatment through a mini-invasive technique. “Our medium-long-term results in 131 patients” (Journal of the Spanish Society of Orthopedic Surgery and Traumatology) Ed. Elsevier.

Mini-invasive and arthroscopic symphysoplasty technique for the treatment of pubic osteopathy in the German journal of surgical techniques in Traumatology and Orthopedics “Operative Orthopädie und Traumatologie” Ed. Springer.

The Press Association of the newspaper La Razón, one of the largest circulation in Spain, has awarded the head of the Hip unit of the Dexeus University Hospital in the section of hip traumatology among applicants from different parts of Spain.

In his speech Ribas thanked the members of his team and orthopedics and traumatology service of Icatme. Dr. Charlemagne Cardenas member of the Unit, Dr. Eugenio Jimeno, medical director of Icatme and Dr. David Campos member of Icatme accompanied Ribas at the event, held at the prestigious Westin Palace in Madrid.

This recognition coincides with the third consecutive year in which Icatme is in first place as the best orthopedic surgery and traumatology service in Spain according to the IEH (Hospital Excellence Index, prepared through a vote by the Spanish doctors of the different hospitals in the country).